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  lüll Human intestinal spirochetosis--a review Tsinganou E; Gebbers JOGer Med Sci  2010[Jan]; 8 (ä): Doc01Human intestinal spirochetosis (IS) is a condition defined histologically by the  presence of spirochetal microorganisms attached to the apical cell membrane of  the colorectal epithelium. Intestinal spirochetes comprise a heterogeneous group  of bacteria. In humans, Brachyspira aalborgi and Brachyspira pilosicoli  predominate. Prevalence rates of IS are low where living standards are high, in  contrast to poorly developed areas where IS is common. Homosexuals and  HIV-infected individuals are at high risk of being colonized. Clinical  significance in individual cases has remained unclear up to now. A review of the  literature assumes that invasion of spirochetes beyond the surface epithelium may  be associated with gastrointestinal symptoms which respond to antibiotic  treatment (metronidazole), whereas individuals lacking this feature may be mostly  asymptomatic. Of unknown reason, homosexual and HIV-positive men as well as  children are more likely to be symptomatic irrespective of invasion. Rare cases  of spirochetemia and multiple organ failure have been reported in critically ill  patients with IS.|*Brachyspira[MESH]|*Colitis/epidemiology/pathology/physiopathology[MESH]|*Gram-Negative Bacterial Infections/epidemiology/pathology/physiopathology[MESH]|Colon/*microbiology/*pathology[MESH]|HIV Infections/epidemiology[MESH]|Humans[MESH]|Prevalence[MESH] |